Names:________________________________________________________________________
Summer:________________________________________________________________________
Street City State/Zip
Winter: ________________________________________________________________________
Street City State/Zip
Phone:_______________________________
Email: ________________________________
☐$65 Couple
☐$90 Sustaining Membership
☐$35 Individual
☐$40 Couple 17-30 years old
☐$20 Individual 17-30 years old
Join the Summer Dance Club
Application for Membership for the 2022 Summer Dance Club
Mail to:
Lakeside Dance Club
Olivia Kahrs
411 2nd St SE
Glenwood MN 56334
To join:
• Print this page
• Complete form
•Make check to:
•“Summer Dance Club”
•Mail form, check and copy of Proof of Vaccination
Email the Summer Dance Club danceclub@lakesideballroom.org
Mail to:
Lakeside Dance Club
Olivia Kahrs
411 2nd St SE
Glenwood MN 56334
This years membership will be available only with proof of vaccination.
TBA